Suppose you run into a scenario where you have entered a patient's insurance payers in the wrong order (IE: Primary is actually the secondary and visa versa). In that case, you can easily re-order the patient's policies to reflect the correct order.
Keep in mind: You CAN NOT perform this process if EOBs have been posted to charges covered by the policy that needs to be re-ordered. Before proceeding, you will have to completely DELETE the EOBs, Re-Order the policy by following the steps below and then repost the EOBs back to the Patient(s)/Charges.
I cannot stress this enough. If you do not, you will walk through the whole process and receive this error in your final stages which will halt you in your tracks until you remove the posted EOBs.
If you are not sure how to see what EOBs are connected to charges, you can go to the patient's file, ledger, and the charges tab. Then select the +sign sitting to the left of the charge
It will then open up the drop-down showing details of an EOB that is connected.
Then you can go to Billing>Completed EOBs>Select the particular EOB and select DELETE.
How to Re-Order a Patient's Policy
In my example: you will see that Medicare is primary and Blue Cross Blue Shield is Secondary.
Step 1: Go to the Patient File>Insurance Tab>Select Edit
Step 2: Choose Re-order Policies>Next
Step 3: While Primary is Highlighted, Choose the Down Arrow to make Primary the Secondary.
Again you see Medicare as Primary and BCBS is Secondary
Once you have selected the down arrow, you will see what was once the primary is now in the secondary location, as you do in my image. Now it's Time to Choose NEXT.
Now you see BCBS displays as Primary and Medicare is Secondary.
Step 4: Now Select Edit Policy
It's time to make sure the correct information is entered into each policy as you have now changed their role.
Step 5: Choose Primary>Next
You will now see the same data listed for when this policy was the Secondary, so we need to make sure it reflects the correct info now that it's the Primary insurance. Focus on the areas I have pointed to with arrows.
- Make sure to enter policy responsibility
- Connect a Fee Schedule if one is needed
- Enter Policy limits if you have that data
- Change 11d to Yes as there is another policy
- Remove Box 9 data under the primary tab as that is the old secondary info
- And any other data you need to place in...
After data is changed, choose NEXT
Step 6: Choose Edit Policy again>Next
Step 7: Select Secondary>Next
You will now see the same data listed for when this policy was the Primary, so we need to make sure it reflects the correct info now that it's the Secondary insurance policy. Focus on the areas I have pointed to with arrows.
- Remove policy coverage as it no longer reflects when secondary
- Remove Policy limits as it no longer affects the patient's ledger
- Change 11d to No as there is not another policy following the secondary policy (unless there is a tertiary policy)
- Remove Box 9 data under the primary tab as that is the old secondary info and place the new secondary policy ID etc on the primary tab of the box 9s area to reflect the policy that is now the secondary.
- And any other data you need to place in or take out...
After data is changed, choose NEXT
Step 8: If you are done editing all data Select Finished>Next
Step 9: Choose the Start date for when this change should take place and Choose Next
In my example, this patient's insurance should have always been entered where BCBS should be the Primary and Medicare is the Secondary, so I would choose a start date BEFORE my initial policy entered was entered. In my example, my initial policy start date (indicated as #1) was 1/1/2016 so I am going to change it to 12/31/2015 and select Next.
The system will now confirm that you would like to create a new insurance policy. If you are satisfied select OK.
Now Select Finished
Once your policy has been added in, you will see it alongside the other policy that had the incorrect data.
Step 10: Now it's time to remove the policy with the incorrect data. Select the prior policy and select DELETE.
The system will ask you to confirm that you would like to delete the policy by selecting YES
The system will show you any write-offs that would be removed from charges by proceeding. If there is a dollar amount displayed, those write-offs would need to be re-entered unless they no longer apply. If you would like to proceed, choose OK
Once you are finished, you will have a display of one insurance policy with all of the correct data.
Now if you are needing to rebill claims, you are ready to do so.